Orthopedic splints are typically used during the first few days of a serious injury such as a fracture, ligament tear or other injury that needs to be stabilized while swelling subsides. Splints are typically partially circumferential or they may wrap around an elbow or ankle and extend up both sides allowing a space on either side. They allow for swelling to occur and are typically wrapped with an Ace-type bandage or the like, which is elastic and may provide compression, yet stretches to accommodate swelling. A complication, Compartment Syndrome, may occur if an injury is casted too soon or splinted too tightly which causes tissue to rapidly die from pressure buildup. Temporary proper splinting mitigates most complications in this regard. Typically, after 4-10 days, the splint is removed for procedures to reduce fractures, surgery or the like.
Conventional splints may be constructed from uncured plaster-impregnated fabric, or fiberglass impregnated with resin that is water activated. They are initially pliable and soaked in water to activate the curing process. Such conventional splints typically come in rolls or pre sized blanks.
While conventional splints are sufficient for their intended purpose, they do exhibit a number of drawbacks which can be improved upon. For example, some sort of padding must be applied to the limb prior to applying the splint. The splint material must be soaked in water to begin the curing process, and variables such as water temperature and room humidity can alter the cure time for the splint material. Once wetted, the splint material is applied over the padding, which must be kept in proper alignment to be effective. Prior to wetting, the splint material is trimmed to a rough desired shape, but upon wetting and application to a patient, additional trimming of the material is often needed. The process is quite messy, and must be carried out very quickly before the splint material begins to cure. Initial curing can start in 2-5 minutes depending on the product and water temperature used. Once initiated, there is no stopping it and the application process must be completed with precise timing to allow for the body part to be aligned, reduced in fracture or otherwise completed before the splint cures. This process requires considerable training and the practitioner must have the splint in place in time to make the final alignment while the splint is still soft enough. Often, there is a minor complication or the splint is wetted too early or too warm and the curing starts during application so there is not enough time to finish the job properly before curing. In this case, the splint must be discarded and the process started over. This not uncommon occurrence is very wasteful, time consuming and costly, not to mention uncomfortable for the injured patient. Wrapping the padding and splint material can often take two people to support and wrap, and the manipulation is often painful to the patient.
On occasion, for a complicated reduction or alignment of a fracture or other injury, an X-Ray or fluoroscope view is needed during the procedure to see through the body to accomplish the correct procedure. Fiberglass and plaster materials tend to scatter X-rays and are somewhat impenetrable, so the view is typically obscured. These poor images can pose problems and the images must often be made with the patient at odd angles so as to image through the body without imaging through much of the splint. This can require complicated alignment of the machinery and patient which can cause great discomfort and complication.
Additionally, complicated reduction and alignment procedures may require a short period of sedation of the patient as the pain is too great to endure. The patient could react and possibly spoil the procedure. All of this can require a number of qualified people in close proximity doing several procedures at once. Along with the usual practitioners, the group can grow quite large. Everything must be orchestrated precisely and timed with the curing of the splint.
Another concern with conventional splinting materials and techniques is the wet environment created during their use. Because plaster and fiberglass splints will typically remain damp for 12 hours or more as the moisture slowly dissipates from the splint and padding through the Ace-type wrap, the moist environment from the splint combined with the body's heat and moisture provides the ideal place for bacterial reproduction.
This wet insulated environment also can provide a great deal of discomfort to the patient, especially in warm climates. Additionally, both fiberglass and plaster are virtually sealed against moisture passing through them so the splints do not breath or allow moisture to easily escape from inside near the body. Any moisture management must be provided by the thick padding or other wrapping.
In view of the drawbacks of conventional splints, a need exists for an improved splint which is less messy, requires fewer personnel to apply, has less likelihood of wasted material due to improper application, and is more comfortable and hygienic for the patient.
One proposed improvement on conventional splints is described in commonly assigned U.S. Published Patent Application No. 2012/0101417 to Joseph, which describes a splint having a composite laminate construction, consisting of thermoformable middle layer, and outer layers of foam and/or fabric which represents an improvement on conventional splints. Opportunities for improvement on the splints described therein still exist, however.
Additionally, prior splint constructions utilizing one or more polymer layers for rigidity typically include either a thin layer of polymer sheet material which is prone to flexing and twisting, or a thicker layer which can provide sufficient rigidity but is unable to be formed into complex shapes or contours and is unacceptably heavy.
A need exists, therefore, for an improved construction for splints which is lightweight, formable to the contours of a patient's anatomy, and which is sufficiently rigid to support the injury.